Americans’ attitudes toward COVID-19 preventive and mitigation behaviors and implications for public health communication

Abstract

PURPOSE: Identifying drivers of behavior is essential to develop effective messaging around COVID-19 prevention and mitigation. Our study assessed for behavioral antecedents of social distancing, wearing face coverings, and sheltering in place during the onset of the COVID-19 pandemic. Although ours is an early assessment, understanding motivation for behavior will remain critical as U.S. vaccination uptake has stalled and variants continue to pose a health threat.

DESIGN: Cross-sectional survey; Setting: Online assessments in April 10-13 and 17-20, 2020; Subjects: 2,279 U.S. adults identified through a national, probability-based web panel (34% response rate). Measures: self-reported behavior, perceived effectiveness and risk, worry, social norms, and knowledge.

ANALYSIS: Multivariable regression analyses.

RESULTS: Most Americans reported social distancing (91%) and sheltering in place (86%). Just over half reported wearing face coverings (51%), whereas more (77%) said they intended to do so. Perceived effectiveness of the behavior was consistently associated with each outcome (OR = 2.34, 1.40, 2.11, respectively; all P < .01). Perceptions about the extent to which others should comply with behavior (social norms) were strongly associated with intentions to wear a face covering only (OR = 6.30, 95% CI 4.34-9.15; P < .001) and worry about getting COVID-19 was associated with sheltering in place and social distancing (OR = 2.63, 95% CI 1.15-5.00; 4.91, 95% CI 1.66, 14.50, respectively; all P < .05).

CONCLUSION: Behavioral constructs were strongly associated with COVID-19 preventive and mitigation behaviors and have implications for communication.